RESUMO
PURPOSE: To compare the clinical features and antibiotic susceptibility of ocular methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA). DESIGN: Cross-sectional study. METHODS: The Proctor clinical laboratory database was reviewed to identify all ocular isolates of S. aureus collected between July 1, 1998 and July 31, 2006. RESULTS: Of 915 S. aureus isolates, there were 88 MRSA isolates in 41 different patients. The proportion MRSA increased from 4.1% in 1998 to 1999 to 16.7% in 2005 to 2006. A total of 78.0% of patients with MRSA had blepharoconjunctivitis, 2.4% had cellulitis, 2.4% had dacryocystitis, 14.6% had keratitis, and 2.4% had endophthalmitis. The diagnoses associated with MSSA were not statistically different. A total of 63.6% of MRSA isolates were sensitive to bacitracin, 100% to vancomycin, 14.8% to ciprofloxacin, 14.8% to erythromycin, 97.7% to sulfisoxazole, and 93.2% to tetracycline. CONCLUSIONS: MRSA has become a more common ocular pathogen but, as with MSSA, causes mild disease. MRSA should be treated with vancomycin.
Assuntos
Antibacterianos/uso terapêutico , Infecções Oculares Bacterianas/microbiologia , Resistência a Meticilina , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Blefarite/microbiologia , California/epidemiologia , Conjuntivite/microbiologia , Estudos Transversais , Dacriocistite/microbiologia , Endoftalmite/microbiologia , Humanos , Ceratite/microbiologia , Meticilina/uso terapêutico , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estudos Retrospectivos , Staphylococcus aureus/efeitos dos fármacosRESUMO
A 21-year-old US soldier received a penetrating eye injury while fighting in Iraq and was treated with evisceration. Sympathetic ophthalmia developed, which responded well to steroid treatment. This is the first case of sympathetic ophthalmia after a war injury reported since World War II.
Assuntos
Ferimentos Oculares Penetrantes/complicações , Oftalmia Simpática/etiologia , Guerra , Adulto , Biópsia , Quimioterapia Combinada , Evisceração do Olho , Ferimentos Oculares Penetrantes/cirurgia , Seguimentos , Glucocorticoides/administração & dosagem , Humanos , Iraque , Masculino , Oftalmia Simpática/tratamento farmacológico , Oftalmia Simpática/patologia , Soluções Oftálmicas , Prednisolona/administração & dosagem , Prednisolona/análogos & derivados , Prednisona/administração & dosagem , Pró-Fármacos/administração & dosagemRESUMO
A case of subretinal hemorrhage associated with cytomegalovirus (CMV) retinitis in a human immunodeficiency virus-positive woman is described. The patient was found to have an exudative retinal detachment involving the fovea, subretinal hemorrhage, cotton wool spots, and active CMV retinitis temporal to the exudative detachment. No evidence of systemic coagulopathy was found. Although unusual, subretinal hemorrhage may be observed in association with CMV retinitis in the absence of a systemic coagulopathy.
